In February 2001, foot-and-mouth disease (FMD) was confirmed in Great Britain. A major epidemic developed, which peaked around 50 cases a day in late March, declining to under 10 a day by May. By mid-July, 1849 cases had been detected. The main control measures employed were livestock movement restrictions and the rapid slaughter of infected and exposed livestock. The first detected case was in south-east England; infection was traced to a farm in north-east England to which all other cases were linked. The epidemic was large as a result of a combination of events, including a delay in the diagnosis of the index case, the movement of infected sheep to market before FMD was first diagnosed, and the time of year. Virus was introduced at a time when there were many sheep movements around the country and weather conditions supported survival of the virus. The consequence was multiple, effectively primary, introductions of FMD virus into major sheep-keeping areas. Subsequent local spread from these introductions accounted for the majority of cases. The largest local epidemics were in areas with dense sheep populations and livestock dealers who were active during the key period. Most affected farms kept both sheep and cattle. At the time of writing the epidemic was still ongoing; however, this paper provides a basis for scientific discussion of the first five months.
Estimating detailed transmission trees that reflect the relationships between infected individuals or populations during a disease outbreak often provides valuable insights into both the nature of disease transmission and the overall dynamics of the underlying epidemiological process. These trees may be based on epidemiological data that relate to the timing of infection and infectiousness, or genetic data that show the genetic relatedness of pathogens isolated from infected individuals. Genetic data are becoming increasingly important in the estimation of transmission trees of viral pathogens due to their inherently high mutation rate. Here, we propose a maximum-likelihood approach that allows epidemiological and genetic data to be combined within the same analysis to infer probable transmission trees. We apply this approach to data from 20 farms infected during the 2001 UK foot-and-mouth disease outbreak, using complete viral genome sequences from each infected farm and information on when farms were first estimated to have developed clinical disease and when livestock on these farms were culled. Incorporating known infection links due to animal movement prior to imposition of the national movement ban results in the reduction of the number of trees from 41 472 that are consistent with the genetic data to 1728, of which just 4 represent more than 95% of the total likelihood calculated using a model that accounts for the epidemiological data. These trees differ in several ways from those constructed prior to the availability of genetic data.
Clinical and laboratory investigations of five outbreaks of foot-and-mouth disease (FMD) were made during the early stages of the 2001 epidemic in the UK. The first outbreak, confirmed on February 20, was at an abattoir in Essex which specialised in the processing of culled sows and boars. On February 23, the disease was confirmed at a pig farm in Northumberland which held cull sows and boars fed on waste food; the findings indicated that it was the first of the five premises to be infected. The disease had probably been present since early February, and it was the most likely origin of the epidemic. The other premises investigated were a waste food-fed cull sow/boar pig unit in Essex, approximately 30 km from the abattoir, which was probably infected at the same time or before the abattoir, a sheep and cattle farm approximately 6 km from the Northumberland pig farm, which was probably infected by airborne virus from it in the period immediately before February 13, and a sheep and cattle farm in Devon which had clinical disease from February 20 and was probably infected by sheep transported from Northumberland on February 13 which arrived on February 15.
The results of epidemiological investigations suggest that livestock on up to 79 premises, spread widely throughout the British Isles, may have been exposed to infection by foot-and-mouth disease (FMD) virus by the movement of infected sheep before the first case of the disease was confirmed at an abattoir in Essex on February 20, 2001. A further 36 premises may have been infected by this route before the national livestock movement ban was imposed on February 23.
Between January 6 and April 23, 1997, 11 outbreaks of Newcastle disease were confirmed in Great Britain, four in broiler chickens and seven in turkeys. Although the viruses isolated gave intracerebral pathogenicity indices in day-old chicks between 1.65 and 1.95, the clinical signs of disease in field infections were variable and not always associated with high mortality, especially in turkeys. Epidemiological investigations indicated that the majority of the outbreaks occurred as a result of secondary spread by human agency from two or more primary infected flocks. The presence of similar outbreaks in Scandinavian countries in 1996 and the unusual patterns of movement of migratory birds at the end of 1996 and beginning of 1997 suggest they may have been responsible for the primary introduction of the causative virus into Great Britain.
The foot-and-mouth disease epidemic in Dumfries and Galloway in south-west Scotland comprised 177 infected premises (IPS) in 24 geographical clusters, and ran from March 1 until May 23, 2001. Initial seeding of infection was by livestock (predominantly sheep) that had passed through Longtown Market in adjacent Cumbria. Thereafter, spread within existing, and to new, clusters was associated with the movement of personnel and vehicles, with further transmission by Longtown Market contacts and across common boundaries. Sheep and cattle premises were equally affected. After the peak of the epidemic at the beginning of the third week of March, the upper possible limit of attack rates for premises contiguous to IPS, and premises within 3 km, remained around 10 per cent, with new clusters emerging more distantly. Control procedures included traditional methods of slaughter of all animals on IPS and, elsewhere, of animals considered by veterinary assessment to be Dangerous Contacts; movement restrictions; enhanced biosecurity; tracing of potential sources and spread of virus; and surveillance of premises subsequently considered at risk. These methods were supplemented by the novel pre-emptive slaughter, without veterinary assessment, of all susceptible livestock on all premises contiguous to IPS, and of small ruminants and pigs within a 3 km radius (known as the Protection Zone) around IPS. In total, approximately 80,000 cattle, 564,000 sheep, 2600 pigs and 500 goats were slaughtered, the novel methods accounting for 29 per cent of all cattle and 75 per cent of all sheep killed. Limitations of existing national databases necessitated the development of local databases to administer control procedures.
An analysis was made that calculated the risk of disease for premises in the most heavily affected parts of the county of Cumbria during the foot-and-mouth disease epidemic in the UK in 2001. In over half the cases the occurrence of the disease was not directly attributable to a recently infected premises being located within 1.5 km. Premises more than 1.5 km from recently infected premises faced sufficiently high infection risks that culling within a 1.5 km radius of the infected premises alone could not have prevented the progress of the epidemic. A comparison of the final outcome in two areas of the county, south Penrith and north Cumbria, indicated that focusing on controlling the potential spread of the disease over short distances by culling premises contiguous to infected premises, while the disease continued to spread over longer distances, may have resulted in excessive numbers of premises being culled. Even though the contiguous cull in south Penrith appeared to have resulted in a smaller proportion of premises becoming infected, the overall proportion of premises culled was considerably greater than in north Cumbria, where, because of staff and resource limitations, a smaller proportion of premises contiguous to infected premises was culled.
After the foot-and-mouth disease (FMD) epidemic in Dumfries and Galloway in south-west Scotland in 2001, serosurveillance of sheep remaining in the 3 km radius Protection Zones around Infected Premises (IPS), and within a 10 km radius of IPS, revealed no evidence of infection. The epidemic was brought under control by a range of traditional techniques: slaughter of all animals on IPS and of veterinary-assessed Dangerous Contacts (DCS), movement restrictions, biosecurity, tracing of potential sources and spread of virus, and surveillance of At-Risk premises. Novel pre-emptive slaughter of FMD-susceptible animals on premises contiguous to IPS, and small ruminants and pigs on premises within 3 km of IPSs, commenced after the epidemic had peaked. Most of the traditional control procedures were undertaken quickly and with appropriate priority. Animals on IPS were usually slaughtered within one day of confirmation, and veterinary-assessed DCS within two days of confirmation of relevant IPS (a median of two days). The pre-emptive contiguous and 3 km culls took somewhat longer (medians of five and 17 days, respectively). IPS were most commonly identified as a result of reporting by farmers or their veterinarians (72 per cent of IPS); veterinary clinical patrols identified 16 per cent, while veterinary assessment of DCS and tracing each identified 5 per cent. No evidence of infection was found on any pre-emptively contiguously culled premises, and IPS were declared only on three 3 km cull premises. The time from estimated first lesion to end of slaughter on an IP was found, by regression analysis, to be a key component in effective control, manifested by a reduction in the estimated dissemination rate (EDR); there was little evidence that the intensity of contiguous culling affected the EDR. Patrols and serological surveillance of residual animals within 10 km of IPS, supported by more extensive evidence from elsewhere in the UK, suggested that cryptic infection in sheep was not widespread. Ultimately, there was insufficient evidence to support the effectiveness of 3 km pre-emptive culling as a control procedure.
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